- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $10,232.93 / $23,988.33
| Facility | | $4,786.30 | $10,232.93 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $5,370.32 / $16,982.44
| Facility | | $66.07 | $5,370.32 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,467.37 / $7,413.10
| Facility | | $758.58 | $3,467.37 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $1,412.54 / $1,995.26
| Professional | | $741.31 | $1,412.54 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,479.11 / $2,691.53
| Professional | | $1,174.90 | $1,479.11 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $33,884.42 / $33,884.42
| Facility | | $16,595.87 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,659.59 / $2,884.03
| Facility | | $1,230.27 | $1,659.59 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $11,748.98 / $25,118.86
| Facility | | $5,248.07 | $11,748.98 | $25,118.86 |